Microenvironment drug resistance in multiple myeloma: emerging new players
// Lucia Di Marzo 1,* , Vanessa Desantis 1,* , Antonio Giovanni Solimando 1 , Simona Ruggieri 2 , Tiziana Annese 2 , Beatrice Nico 2 , Ruggiero Fumarulo 3 , Angelo Vacca 1 and Maria Antonia Frassanito 3 1 Department of Biomedical Sciences and Human Oncology, Internal Medicine Section, University of Bari Medical School, Bari, Italy 2 Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy 3 Department of Biomedical Sciences and Human Oncology, General Pathology Section, Bari, Italy * These authors have contributed equally to this work Correspondence to: Angelo Vacca, email: // Keywords : cancer-associated fibroblasts, drug resistance, exosomes, microRNAs, multiple myeloma Received : May 05, 2016 Accepted : July 11, 2016 Published : September 13, 2016 Abstract Multiple myeloma (MM) drug resistance (DR) is a multistep transformation process based on a powerful interplay between bone marrow stromal cells and MM cells that allows the latter to escape anti-myeloma therapies. Here we present an overview of the role of the bone marrow microenvironment in both soluble factors-mediated drug resistance (SFM-DR) and cell adhesion-mediated drug resistance (CAM-DR), focusing on the role of new players, namely miRNAs, exosomes and cancer-associated fibroblasts.